Healthcare Provider Details

I. General information

NPI: 1447175047
Provider Name (Legal Business Name): THE WELL MISSION FAMILY COUNSELING CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 MISSION ST
SANTA CRUZ CA
95060-3715
US

IV. Provider business mailing address

120 MISSION ST
SANTA CRUZ CA
95060-3715
US

V. Phone/Fax

Practice location:
  • Phone: 831-334-0691
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JESSICA REYNOLDS
Title or Position: CLINICAL DIRECTOR
Credential: LMFT
Phone: 831-334-0691